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Subtotal parathyroidectomy for secondary hyperparathyroidism in chronic renal failure

Published online by Cambridge University Press:  29 June 2007

F. Fabretti ,
V. Calabrese ,
V. Fornasari  and
I. Poletti
F. Fabretti
Affiliation:
Department of ENT, Ospedali Riuniti di Bergamo (Italy).
V. Calabrese*
Affiliation:
Department of ENT, Ospedali Riuniti di Bergamo (Italy).
V. Fornasari
Affiliation:
Department of ENT, Ospedali Riuniti di Bergamo (Italy).
I. Poletti
Affiliation:
Department of Nephrology Ospedali Riuniti di Bergamo (Italy).
*
Dr Vinccnzo Calabrcse, Division O.R.L., Ospedali Riuniti, L.go Barozzi. 1, 24100 Bergamo, Italy.
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Abstract

Twenty-seven patients on chronic haemodialysis and with secondary hyperparathyroidism underwent subtotal parathyroidectomy during the period 1985–1989. The operation was indicated by severe clinical symptoms and evidence of radiological abnormalities not responsive to conservative treatment (low phosphorus diet, phosphate binding substances, oral calcium and vitamin D). If despite intensive medical management, inadequate control of parathyroid hyperplasia continues surgical intervention becomes necessary. Ultrasonography was performed pre-operatively in all 27 cases and detected 42 of 99 glands (42.5 per cent). Also scintigraphy was carried out in every patient but it gave a relatively low detection rate (24.5 per cent). Surgery was followed by improvement in 20 patients and progression of hyperparathyroidism in seven cases. Three of the seven patients failed to improve after subtotal parathyroidectomy, necessitating a reintervention; the remaining four responded sufficiently to medical therapy. From our experience we conclude that subtotal parathyroidectomy for renal hyperparathyroidism is recommended.

Keywords

Parathyroid surgeryHyperparathyroidismsecondaryRenal failure
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 105 , Issue 7 , July 1991 , pp. 562 - 567
Copyright
Copyright © JLO (1984) Limited 1991

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